The term 'adverse childhood experiences' is used to describe a wide range of stressful or traumatic experiences that children can be exposed to whilst growing up. ACEs range from experiences that directly harm a child (such as suffering physical, verbal or sexual abuse, and physical or emotional neglect) to those that affect the environment in which a child grows up (including parental separation, domestic violence, mental illness, alcohol abuse, drug use or incarceration).

A Blackburn with Darwen study found that almost half (47%) of adults across the borough have suffered at least one ACE, with 12% of adults in Blackburn with Darwen having suffered four or more ACEs. The study has shown that the more ACEs individuals experience in childhood, the greater their risk of a wide range of health-harming behaviours and diseases as an adult.

What must be remembered is that ACEs can be prevented. The work that we are doing across Blackburn with Darwen aims to both prevent ACEs occurring in the first place wherever possible, and to prevent the consequences of ACEs in those that have already experienced them. If you have been affected by any of the issues raised, please contact your GP.

The frequency of ACEs

ACEs are unfortunately all too common. Our Blackburn with Darwen study found that almost half (47%) of our adult population (aged 18-69 years) had at least 1 ACE, with many people having higher ACE scores.

For our population:

53% had experienced 0 ACEs

19% had experienced 1 ACE

16% had experienced 2-3 ACEs

12% had experienced 4+ ACEs.

This is similar to the English ACE population study which found the following across England. For further information, please see the original ACEs study.

The impact of ACEs

ACEs can have a negative impact on development in childhood and this can in turn give rise to harmful behaviours, social issues and health problems in adulthood. There is now a great deal of research demonstrating that ACEs can negatively affect lifelong mental and physical health by disrupting brain and organ development and by damaging the body's system for defending against diseases. The more ACEs a child experiences, the greater the chance of health and/or social problems in later life.

Research shows that there is a strong dose-response relationship between ACEs and poor physical and mental health, chronic disease (such as type II diabetes, chronic obstructive pulmonary disease; heart disease; cancer), increased levels of violence, and lower academic success both in childhood and adulthood.

Evidence from Blackburn with Darwen (2012) showed that there was increased risk (adjusted odds ratio) of having health and social problems in adulthood for those individuals who had experienced 4+ ACEs, compared to those with no ACEs.

Individuals with 4 or more ACEs were:

4.5 times more likely to have become pregnant or got somebody pregnant under 18 years of age

30.6 times more likely to have had a sexually transmitted infection (STI)

1.8 times more likely to be morbidly obese

2.3 times more likely to have liver or digestive disease

1.5 times more likely to have stayed overnight in hospital in the last 12 months

3.7 times more likely to a regular heavy drinker

3.9 times more likely to be a current smoker

9.7 times more likely to be a heroin or crack user

5.2 times more likely to have been hit in the last 12 months

7.9 times more likely to have hit someone in the last 12 months

8.8 times more likely to have been in prison or cells

Preventing ACEs

Whether you are an adult looking to reverse the impact of your own ACEs, or a parent or caregiver keen to make sure that your children do not grow up with ACEs themselves, ACEs is preventable. Stable, nurturing adult-child relationships and environments help children develop strong cognitive and emotional skills and the resilience required to flourish as adults. By encouraging such relationships ACEs can be prevented, even in difficult circumstances, and it is crucial to support and nurture children and young people as they develop and grow. For adults who experienced ACEs in their childhood, support is available to minimise the impact of ACEs on their health, relationships and lives in general.

Blackburn with Darwen's approach to reducing ACEs

There is a growing recognition in Blackburn with Darwen that early intervention and collaborative working are essential to reducing the impact of ACEs. The Specialist Public Health Team at Blackburn with Darwen Borough Council has worked closely with stakeholders to raise the awareness and understanding of ACEs amongst professionals, communities, families, children and young people. The vision of the Borough is to reduce the number of adversities experienced by people in Blackburn with Darwen and to build resilience of those who have already experienced ACEs.

There have been a number of approaches and initiatives that have been developed across the borough:

Raising awareness of ACEs is deeply embedded within our Children's Partnership Board (a sub-group of the Health and Wellbeing Board).

We have written the reporting and recording of ACEs into specific public health contracts (such as those for sexual health and substance misuse).

We have worked with Lancashire Constabulary to bring ACEs into the Early Action Programme.

We have worked with Lancashire Care Foundation Trust to train staff to be able to routinely enquire about ACEs, through the REACh (Routine Enquiry in Adverse Childhood Experiences) initiative.

We have worked with a local secondary school to be ACE-Aware and ACE-informed, through the EmBRACE (Emotional and Brain Resilience in Adverse Childhood Experiences) initiative.

We have been in discussions with various stakeholders to raise the awareness of ACEs and have presented at local, regional, national and international conferences.

We have started to create an environment to support social movements around ACEs.

We have developed an animation on ACES in collaboration with Public Health Wales.

If you would like to know more about ACEs, the work of the Specialist Public Health Team, or be involved, please contact us.

Available support

Although the effects of ACEs can last a lifetime, the good news is that they don't have to. By seeking support, you can both reduce the impact of ACEs on your own life and break the cycle to prevent ACEs occurring in the next generation. This support can come from something as simple as a chat with a friend or family member, via your GP, or through one of the wide range of local and national organisations below that will help you recognise, work through and reverse the impact of ACEs for yourself or somebody you care about.

Drugs, alcohol and crime

ADFAM gives information and support for the families of drug and alcohol users

Alcoholics anonymous - if your drinking is causing you problems and you wish to stop drinking, call 0800 917 7650

Go2 - Blackburn with Darwen young people's drug and alcohol servicecan support you with alcohol and drug abuse (including cannabis, heroin and ecstasy, 'legal highs', prescription and over the counter medication and multiple drug and/or alcohol use). They offer free and confidential advice and information for anyone under 25, as well as support for the whole family. You can call them on 01254 495014 or visit their Facebook and Twitter pages.

Inspire -Blackburn with Darwen's integrated prevention and recovery service offers a wide range of support for anyone worried about their own or somebody else's substance/alcohol use. They offer advice and guidance to individuals and family members through rapid and open access assessment, leading to support and treatment. You can call them on 01254 495014 or visit their Facebook page.

UK Narcotics Anonymous is a society of recovering addicts for whom drugs had become a major problem, that meets regularly to help each other stop using and stay clean. You can call 0300 999 1212 for support.

Abuse and relationships

The WISH centre is often the first point of contact for people in Blackburn with Darwen who are experiencing domestic abuse. Fully qualified and specialist staff are available to discuss choices and options in a non-judgemental way, providing emotional and practical support.

The Wish Centre is often the first point of contact for people in Blackburn with Darwen who are experiencing domestic abuse. Trained staff are available to discuss choices and options in a non-judgemental way, providing emotional and practical support. You can call them on 01254 260465 or visit their Twitter page.

NSPCC is a major UK charity specialising in child protection and the prevention of cruelty to children; their aim is to end cruelty to children. If you are an adult that experienced abuse as a child, the NSPCC can also provide help and advice. Help for adults concerned about a child can call 0808 800 5000, text 88858 or visit their website.

Women's Aid is a national charity working to end domestic violence against women and children. Call 0808 2000 247 for support.

Relate is a counselling service working to promote health, respect and justice in couple and family relationships. You can call 0300 100 1234.

Mental health

Big White Wall- if you're experiencing a tough time at home or work or struggling with mental health issues, you can now access free online professional and peer support. Big White Wall provides safe, anonymous and free online support for over 16's, 24/7, with a supportive community, information and self-help resources and trained counsellors online at all times. You can call them on 01254 495014 or visit their Facebook and Twitter pages.

Lancashire Mind is a passionate movement leading the mental wellbeing revolution in Lancashire. We campaign to make your mental wellbeing a local priority, and help you find the tools you need to manage, maintain and improve your mental wellbeing. For support, call 01257 231660 or visit their Facebook and Twitter pages.

Samaritans - Talk to us any time you like, in your own way, and off the record – about whatever's getting to you. You don't have to be suicidal. We know a lot about what can help you through tough times. We can help you explore your options, understand your problems better, or just be there to listen. Call 01254 662424 (local call charges apply) or the national line on 116 123 (this number is free to call) for advice. You can also visit their Facebook and Twitter pages.